Tennis elbow

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Tennis elbow- also known as lateral epicondylitis- is an overuse injury caused by injury to the common extensor tendon of the elbow.

The trigger is trauma to the tissues at the lateral epicondyle. While tennis players do get this condition- hence, the name... most people who are affected do so through other activities. Repetitive stress or trauma to the common extensor tendons and muscles is the primary cause.

The pain is aggravated by dorsiflexion of the wrist, supination (turning your palm upward) of the hand, or grasping with a straight wrist or elbow. Just reaching into the refrigerator to get a carton of milk can cause pain.

Routine activities such as holding an umbrella or shaking hands can be excruciating.

The main symptom of tennis elbow is tenderness and pain that starts at the lateral epicondyle of the elbow. The pain may spread down the forearm.

The physical exam is often most helpful in diagnosing tennis elbow.

Imaging procedures such as diagnostic ultrasound and MRI can confirm the diagnosis.

The key to conservative (nonsurgical) treatment is to help the tendon heal.

If the problem is caused by acute inflammation, anti-inflammatory medications such as ibuprofen may provide some relief. If symptoms persist, a single glucocorticoid injection may be of benefit. It is key to understand that more than one glucocorticoid injection may be harmful.

A more physiologic approach to tendon healing is ultrasound-guided needle tenotomy with injection of platelet-rich plasma (PRP). This is curative and helps build new tendon tissue. For more information, go to:


Physical and occupational therapy can be helpful. An elbow strap that wraps around the upper forearm may relieve the pressure on the tendon attachment.

Exercises are used to gradually stretch and strengthen the forearm muscles.

Because tendinosis is often linked to overuse, it's important to reduce repeated strain on the elbow.

If you really are a tennis player, here are a few tips that may help:

1. Work with a coach to improve your technique

2. Make sure that the grip on your racket is the correct size for you

3. Use a more flexible racket

4. String your racket at a lower tension and use a vibration dampener.

5. Strengthen the wrist and forearm muscles.

6. Stretch the forearm and wrist muscles before and after play.

More advice:

1. Ice down your sore elbow, keeping the ice on for 10- to 12-minute intervals, with 20-minute rests between applications

2. Use oral anti-inflammatory medications

3. Apply topical anti-inflammatory creams to the elbow

4. Use a 'counterforce brace' when you play. This band, which fastens around your forearm helps distribute impact forces at the elbow

For more information about tendonitis, visit our sister site:

Tendonitis Tendonitisand provides reliable, accurate, and useful information on tendonitis treatment written by a board-certified rheumatologist. Learn more about how to get tendonitis relief using the most up-to-date methods.

Get more information about tennis elbow and related topics as well as...

• Insider arthritis tips that help you erase the pain and fatigue of rheumatoid arthritis almost overnight!

• Devastating ammunition against low back pain... discover 9 secrets!

• Ignored remedies that eliminate fibromyalgia symptoms quickly!

• Obsolete treatments for knee osteoarthritis that still are used... and may still work for you!

• The stiff penalties you face if you ignore this type of hip pain...

• 7 easy-to-implement neck pain remedies that work like a charm!

• And much more...

Click here Second Opinion Arthritis Treatment Kit

Return to arthritis home page.

Copyright (c) 2004 - All Rights Reserved

How to Beat Arthritis! Get our FREE monthly Ezine and get your life back!

Enter your E-mail Address
Enter your First Name (optional)

Don't worry — your e-mail address is totally secure.
I promise to use it only to send you Insider Arthritis Tips.